Bad-debt write-offs

Billing company rates

• What is the billing company going to do for this rate? If the company is strictly going to bill charges and not be involved in the collection process, a rate of 9 percent to 13 percent is too high.

• How will the billing company follow up on all outstanding charges? If the company is going to regularly follow up with patients and insurance carriers through statements and telephone contact, the above rates are reasonable.

• Does the billing company bill claims electronically, or do most go out on paper? If the billing company won't file the majority of claims electronically, you'll be paying for their inefficiency and you won't receive the optimal value for your dollar.

Time cards and efficiency

• Meet with the entire staff to clearly state your expectations about accurate time recording and efficient use of time. Inform them that you'll be monitoring their performance.

• Listen and respond to any concerns they may have.

• Periodically — or when you suspect a problem — take notes on when employees arrive and leave work. Compare your notes to their time cards daily or when you're preparing payroll. When you do this, be sure to take notes on all employees to avoid allegations that you singled out individuals.

• Meet privately with employees who are padding their time cards or working inefficiently. Describe your concerns — focusing only on the most egregious offenses — listen to the employee's side of the story and restate your expectations.

Most of your employees should modify their performance to meet your reasonable expectations. However, you may continue to experience resistance from some. Just stand firm, and continue to apply your expectations fairly to all employees. You may have to encourage those who don't comply to seek other employment opportunities.